Anaesthesia and Intensive Care最新文献_第4页

During pregnancy, anticoagulant effect of low molecular weight heparin can be determined with both thrombelastography and anti-factor Xa activity, or not? 妊娠期间，低分子肝素的抗凝作用是否可以通过血栓造影和抗Xa因子活性来确定？

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-07-10 DOI: 10.1177/0310057X261453976

Niclas Carlberg, Anna Olsson, Margareta Hellgren, Ove Karlsson

{"title":"During pregnancy, anticoagulant effect of low molecular weight heparin can be determined with both thrombelastography and anti-factor Xa activity, or not?","authors":"Niclas Carlberg, Anna Olsson, Margareta Hellgren, Ove Karlsson","doi":"10.1177/0310057X261453976","DOIUrl":"10.1177/0310057X261453976","url":null,"abstract":"Venous thromboembolism is a common cause of maternal mortality. Many women need regional anaesthesia during vaginal delivery or caesarean section. However, the risk of epidural or spinal haematoma is increased if regional anaesthesia is administered during ongoing thromboprophylaxis with low molecular weight heparin (LMWH). The aims of this pilot study are to evaluate the anticoagulant effect of LMWH during pregnancy by thrombelastography and anti-factor Xa (FXa) activity and their correlations. Sixteen pregnant women were administered dalteparin or tinzaparin from early pregnancy until six weeks postpartum. The anticoagulant effect was determined immediately before and three hours after injection. The target anti-FXa activity was 0.1-0.2 IU/ml pre-injection and less than 0.45 IU/ml post-injection. Thrombelastography variables were assessed at the same time. The correlations between anti-FXa activity and thrombelastography variables were modest, with correlation coefficients at 0.4-0.5. The thrombelastography variable best correlated to anti-FXa activity <0.1 IU/ml was thrombelastography K. The area under the receiver operating characteristic curve for thrombelastography K against anti-FXa activity <0.1 IU/ml was 0.77 (95% confidence intervals 0.64 to 0.91) with sensitivity 0.76 and specificity 0.81. The correlations increased as pregnancy progressed. The anticoagulant effect of LMWH can be measured either by analysis of anti-FXa activity or with thrombelastography. However, the correlation between the two methods is too low to allow replacement of one by the other. Further studies are necessary to determine which of the methods best predicts anticoagulant effect and increased risk of bleeding complications related to delivery or regional anaesthesia.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"445-452"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of novel materials for front-of-neck access simulations. 前颈部通道模拟新材料的评估。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261443357

Monica E Mullally, Laura J Bond, Raja R Palepu, Jeremy S Young, Daniel R Frei

{"title":"Evaluation of novel materials for front-of-neck access simulations.","authors":"Monica E Mullally, Laura J Bond, Raja R Palepu, Jeremy S Young, Daniel R Frei","doi":"10.1177/0310057X261443357","DOIUrl":"10.1177/0310057X261443357","url":null,"abstract":"Neck rescue encompasses a variety of techniques and terms used to describe direct access to the trachea to allow delivery of oxygen into the airway, typically in the context of a 'can't intubate, can't oxygenate' (CICO) scenario. Anaesthetists rely on CICO simulation exercises to obtain competency in neck rescue using commercially available plastic airway models. Recently, innovations in three-dimensional (3D)-printed airway models and 'symbiotic culture of bacteria and yeast' (SCOBY) skins have been trialled for CICO training. We undertook a study to compare the fidelity of a 3D-printed airway model and SCOBY skin model with a commercially available plastic and foam model (Crico-Trainer 'Frova', VBM-Medizintechnik GmbH, Sulz am Neckar, Germany) trialled by 27 volunteer anaesthesia specialists and trainees. Study participants performed neck rescue on all model variants and provided structured feedback. The 3D-printed model with SCOBY skin was found to have the highest fidelity for neck rescue training and was the model preferred by most participants. Model fidelity, environmental impact, and ethical considerations were rated as important or very important by participants. Further studies are needed to confirm these findings in other hospital settings.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"464-468"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postoperative management after oesophagectomy: An evidence-based approach. 食管切除术后的术后处理：循证方法。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-09-01 Epub Date: 2026-07-11 DOI: 10.1177/0310057X261445468

Marija Apostoloska, David Jr Links, David J Bihari, Sumesh Arora

{"title":"Postoperative management after oesophagectomy: An evidence-based approach.","authors":"Marija Apostoloska, David Jr Links, David J Bihari, Sumesh Arora","doi":"10.1177/0310057X261445468","DOIUrl":"10.1177/0310057X261445468","url":null,"abstract":"Oesophagectomy is a complex surgical procedure that requires meticulous multidisciplinary care. The procedure, which typically requires multiple incisions, involves tumour resection and creation of a gastric conduit followed by its anastomosis to the remaining oesophagus in the thorax or the neck. Although respiratory failure is the leading cause of postoperative morbidity, non-invasive ventilation is frequently unfeasible. Special care is required to secure the multiple catheters and drains inserted during the procedure; accidental dislodgement of any of which may increase postoperative morbidity. Among the potential complications of this procedure, the anastomotic site is susceptible to ischaemia because of the limited blood supply of the gastric conduit from the right gastroepiploic artery. Conduit ischaemia and anastomotic leak are the most serious complications and may result in prolonged morbidity or mortality. Furthermore, patients with oesophageal tumours and dysphagia are frequently cachectic, prehabilitation may reduce the incidence of postoperative complications. Dietitian-prescribed intensive nutritional support may limit the extent of postoperative weight loss and the risk of severe complications.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"417-430"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on '2025 ADS/ANZCA/GESA/NACOS clinical practice recommendations on the peri-procedural use of GLP-1/GIP receptor agonists'. 对“2025 ADS/ANZCA/GESA/NACOS关于GLP-1/GIP受体激动剂围手术期使用的临床实践建议”的评论

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-08-14 DOI: 10.1177/0310057X261460073

Daniel Frei, Daniel Ramsay, Adam Hollingworth

引用次数: 0

Response to comment on '2025 ADS/ANZCA/GESA/NACOS clinical practice recommendations on the peri-procedural use of GLP-1/GIP receptor agonists'. 对“2025 ADS/ANZCA/GESA/NACOS关于GLP-1/GIP受体激动剂围手术期使用的临床实践建议”的评论的回应。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-08-14 DOI: 10.1177/0310057X261460074

Benjamin L Olesnicky, Samantha L Hocking, David A Scott, Matthew L Remedios, Michael Horowitz, David A Story, Jerry R Greenfield, Alex Boussioutas, Benedict Devereaux, Sofianos Andrikopoulos, Jonathan E Shaw

引用次数: 0

Desflurane's climate burden and the PFAS legacy of volatile anaesthetics. 地氟醚的气候负担和挥发性麻醉剂的PFAS遗产。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-08-13 DOI: 10.1177/0310057X261467780

Samuel T Costello, Steffen Rex, Alain F Kalmar

{"title":"Desflurane's climate burden and the PFAS legacy of volatile anaesthetics.","authors":"Samuel T Costello, Steffen Rex, Alain F Kalmar","doi":"10.1177/0310057X261467780","DOIUrl":"10.1177/0310057X261467780","url":null,"abstract":"Efforts to reduce the environmental footprint of anaesthesia have focused predominantly on greenhouse gas emissions, with desflurane widely recognised as an extreme climate outlier. In Australia, desflurane accounts for approximately 3% of volatile anaesthetic cases yet contributes nearly 60% of volatile anaesthetic-related greenhouse gas emissions, making its phase-out one of the most effective mitigation measures immediately available to anaesthetists. However, climate forcing represents only one dimension of the environmental burden of volatile anaesthesia. All fluorinated volatile anaesthetics, including sevoflurane, desflurane and isoflurane, meet the Organisation for Economic Co-operation and Development definition of per- and polyfluoroalkyl substances (PFAS) that generate persistent degradation products, most notably trifluoroacetic acid, leading to irreversible accumulation in water, soil and biota. This Point of View examines both dimensions. We argue that desflurane represents a disproportionate climate burden, whereas PFAS pollution is an inherent class effect of volatile anaesthesia. Using quantitative estimates, we illustrate the scale of both impacts and consider the regulatory and ethical implications for Australian practice.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261467780"},"PeriodicalIF":1.5,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Environmental footprint of inhalational paediatric anaesthesia: emission intensity is highest in smaller patients. 吸入式儿科麻醉的环境足迹：小个子患者的排放强度最高。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-08-11 DOI: 10.1177/0310057X261467429

Zaccaria Ricci, Maximilian Fischer, Camilla Di Biase, Sandra Angileri, Irene Steinberg, Domenico Albino, Denise Colosimo

引用次数: 0

When left isn't right: A case series of wrong-sided nerve blocks reported to webAIRS. 当左边不是正确的：向webAIRS报告的一系列错误的神经阻滞病例。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-08-09 DOI: 10.1177/0310057X261467430

Thomas Z Curtis, Joanna R Sutherland, Tracey M Tay, Yasmin Endlich

{"title":"When left isn't right: A case series of wrong-sided nerve blocks reported to webAIRS.","authors":"Thomas Z Curtis, Joanna R Sutherland, Tracey M Tay, Yasmin Endlich","doi":"10.1177/0310057X261467430","DOIUrl":"https://doi.org/10.1177/0310057X261467430","url":null,"abstract":"The aim of this study was to review cases of wrong-sided nerve blockade among the 11,425 incidents reported to webAIRS-a centralised Australian and New Zealand anaesthetic incident reporting system-as of April 2024. Cases were reviewed if a reporter selected 'peripheral nerve blockade' as a main category, or narrative word search identified the terms 'wrong/incorrect/error' and 'site/side'. Seven hundred and seventy-one reports under the category 'peripheral nerve blockade' were reviewed, and 43 incidents were ultimately included for analysis, involving 38 wrong-sided blocks and five near misses. Both quantitative and qualitative factors contributing to laterality errors were assessed by two independent analysers. Although most incidents of wrong-sided block had minimal reported sequelae, one patient required unplanned admission to intensive care, while another had an operation cancelled. Wrong-side blockade remains a 'never event', and its occurrence can have significant physical and psychological consequences for patients. Regional anaesthetic errors are contributed to by various factors that have been well described in previous publications on the topic; however, this study demonstrated a disproportionate commonality in failure to confirm the correct procedural side (63% of cases).","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261467430"},"PeriodicalIF":1.5,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative beta-blocker adherence in noncardiac surgery: Implications for structured patient instruction and perioperative nursing practice. 非心脏手术围手术期β受体阻滞剂依从性：对结构化患者指导和围手术期护理实践的影响。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-30 DOI: 10.1177/0310057X261460079

Daniel L George, Ronald K F Fung

引用次数: 0

Modified-release versus immediate-release opioid use in postoperative lower limb arthroplasty patients: An Australian tertiary centre audit. 下肢关节置换术后阿片类药物的缓释与立即释放：澳大利亚三级中心审计。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-30 DOI: 10.1177/0310057X261462195

Jia Yin Lu, Zhao Hua Qin, Jaime R Worboys, Philip J Corke

引用次数: 0